Means for treating surface wounds



Nov. 29, 1966 J. J. M CARTHY MEANS FOR TREATING SURFACE WOUNDS 2 SheetsSheet 1 Filed Oct. 4, 1965 INVENTOR. JOHN J. MCCARTHY @z/ u/V m Affornevs Nov. 29, 1966 i J. J. M CARTHY 3,288,140

MEANS FOR TREATING SURFACE WOUNDS Filed Oct. 4, 1963 Y 2 Sheets-Sheet 2 INVENTOR.

JOHN J. MCCARTHY I I Cim/wu Attorneys United States Patent 3,288,140 MEANS FOR TREATING SURFACE WOUNDS John J. McCarthy, 2097 Riverside Drive, Lakewood, Ohio Filed Oct. 4, 1963, Ser. No. 314,009 1 Claim. (Cl. 128-248) This invention relates to fluid therapy and, more particularly, to a method and apparatus for treating surface wounds by fluids.

Fluid therapy is frequently prescribed by physicians as a necessary procedure in the post-operative care of a surface wound. Fluids such as water with or without antibiotics induce proper healing of the wound.

The usual manner of treating a wound by fluids is to simply immerse the operative site into a fluid bath. In some instances the water is swirled by a suitable pump to provide some degree of stimulation to the wound.

These procedures have not been totally acceptable to the physician and patient since many wounds are located on areas of the body that cannot be conveniently im mersed. Wounds on the chest or on the abdomen require substantially complete immersion of the body in a tub. Wounds that are located on the head, moreover, are for all practical purposes impossible to treat by fluid therapy.

Immersion in a tub is at times difficult for the patient, particularly after an operation, or if the patient is otherwise enfeebled. Most hospitals are not equipped with a sufficient number of tubs for fluid therapy if they are so equipped at all.

Physicians frequently prescribe the immersion of a wound in an antiseptic dye, such as potassium permanganate, or other highly staining solutions. In these instances, the patient finds to his dismay that major portions of his body are stained after his fluid therapy treatment.

From a medical standpoint, it is undesirable to bring other areas of the body in contact with a fluid medium that is also in contact with a wound since the fluid may act as a carrier for bacteria from those areas to the wound, or vice versa. This is particularly true where it is necessary to employ fluid therapy for abscesses, varicose ulcers, hemorrhoids, vaginal orifice repair operations after delivery, and after perineorrhaphy.

Some areas of the body may be treated by immersing only the affected area, but most areas that are to be immersed require substantially complete body immersion, or are located near areas that should not be immersed. Most of these prior art fluid therapy treatments, moreover, require long soaking periods since a non-turbulent bath has little effect on a wound. Swirling the fluid provides some degree of stimulation to the wound but not enough to actually cleanse the wound by removing foreign particles or other accumulations.

It is an object of this invention to overcome many of the deficiencies of these prior art fluid therapy procedures.

More particularly, it is an object of this invention to provide a fluid therapy treatment and a device for carrying out this treatment that will cleanse and stimulate a wound while confining the treating fluid to the wound and to areas immediately adjacent thereto regardless of the particular location of the wound.

The objects are accomplished by placing a cup-shaped container over the wound, filling the container with fluid, and directing a stream of fluid at a relatively high pressure, through a nozzle in a wall of the cup, through the fluid bath and toward the wound. The stream provides local turbulence in the area of the wound while the fluid is confined by the cup. The wound is maintained at all times in the fluid by an overflow in the cup which is located above the wound and the nozzle.

These and other objects, features, and advantages of 3,288,140 Patented Nov. 29, 1966 the invention will become more fully apparent from the following detailed description and from the accompanying drawings.

In the drawings:

FIGURE 1 is a perspective view of a fluid therapy device according to one aspect of this invention showing the device attached to a conventional toilet seat;

FIGURE 2 is a longitudinal, cross sectional view of the device of FIGURE 1 showing the device in operation;

FIGURE 3 is a perspective view of a fluid therapy device according to a further aspect of this invention showing the device in operation;

FIGURE 4 is a top plan view of a fluid therapy device according to a still further aspect of this invention showing the device in operation; and

FIGURE 5 is a sectional view, the plane of the section being indicated by the line 5-5 in FIGURE 4.

Referring now to the drawings, and particularly to FIGURES 1 and 2, a fluid therapy device 10 is illustrated. The device 10 is particularly suitable for fluid therapy treatments after both hemorrhoid and perineal operations, and includes a cup 11 having a rim 12 that is shaped to surround only the vaginal opening and the body area immediately adjacent to this area or the anal orifice and the body area immediately adjacent to this area. As will hereinafter become apparent, the particular orientation of the cup 11 relative to the body depends on the particular area to be treated and while one of these openings is being treated, the other opening is excluded from the treating agent.

A flange 13 extends downwardly and outwardly from the rim 12 and this flange, in cooperation with an illwardly sloping sidewall 14 of the cup 11 and the rim 12,

results in a fluid-tight seal when the cup 11 is pressed against the skin S, as may be seen in FIGURE 2.

The cup 11 may be molded or otherwise fabricated from plastic, hand rubber, porcelain, or any other material that will not [be affected by or react with medicaments, warm water, and the skin of a patient. It is preferable to fabricate the cup 11 from a relatively inexpensive material so that it may be used by a single individual and then disposed of. The disposal of the cup 11 after treatment is advantageous since it eliminates expensive autoclaving and the risk of cross infection between patients. I

An aperture 15 is provided in the bottom of the cup 11 and a rubber grommet 16 is fitted in this aperture. A stiff plastic tube 17 extends through the grommet 16 and into the cup 11. The grommet 16 provides a fluid-tight seal between the cup and the tube, and prevents axial movement of the tube relative to the aperture. The grommet, however, is flexible and permits non-axial movement of the tube 17 relative to the cup 11.

The end of the tube 17 in the cup 11 is provided with a small nozzle opening 18 and the other end of the tube 17 is curved upwardly. A length of rubber tubing 19 is fitted over the upwardly curved end of the tube 17 and provides fluid communication between the tube 17 and a fluid supply bag 20.

As may be seen in FIGURE 1, the cup 11 is resiliently fixed to a conventional toilet or commode seat 21 by elastic straps 22 and 23. In the embodiment illustrated in FIGURES 1 and 2, the straps 22 and 23 are lengths of hollow rubber tubing having ends that pass through openings in the flange 13 and which are fixed to the flange by pins 24.

As may also be seen in FIGURE 1, a length of wire 25 is provided in a portion of each strip 22 and 23 to provide a flexible, U-shaped clamp 26 at the end of each strap. The clamps 26 are bent to the shape illustrated and over opposite edges of the seat 21.

One end of the cup 11 extends upwardly to form a narrowed peak portion 27. An overflow outlet 28 ,is provided in this peak portion 27 and is, therefore, located above the nozzle opening 18 and above substantially all of the body areas that are encircled by the cup 11. The overflow outlet 28 is in fluid communication with a discharge conduit 29 which extends down the outside Wall of the cup 11 and slightly beyond the bottom of the cup- 11. A length of rubber tubing 30'is fitted over the end of the discharge conduit 29 and is in fluid communication with a bag 31.

In operation for a typical fluid therapy treatment, the cup 11 is mounted on the seat 21, as shown. In the illustrated orientation, with the peak portion 27 pointed toward the front of the toilet or comm-ode, the cup 11 is in position to treat the vaginal opening by fluid therapy. For treatment of the anus, the position of the cup would be reversed so that the peak portion 27 is turned toward the sacrum. In either instance, however, the tube 17 should extend toward the front of the toilet and upwardly between the thighs.

The patient may adjust the pressure of the cup 11 against the area to be treated by sitting on the cup and bending the clamps 26 over the edges of the seat 21 to vary the tension on the straps 22.

After the tension has been adjusted in this manner, the cup 11 is filled with a prescribed treating agent. For a typical treatment, the treating agent would be water at body temperature. The bag 20* is filled with treating agent and the bag is suspended from a hook at about six feet above the cup 11. If the treating agent in the cup- 11 is water at body temperature, the bag 20 is filled with water at about 110 F.

The patient then sits on the toilet seat 21 and adjusts the cup 11 so that it covers only the site of the incision or wound, and excludes all other areas that would besensitive to the treating agent. The patient may then grasp the upwardly turned end of the tube 17 and move it about to direct the stream from the nozzle opening 18 to different portions of the wound. The fine jet stream from the opening 18 would normally irritate the 'wound. In the illustrated environment, however, the stream is, in effect, cushioned by the fluid in the cup -11. The flow from the opening 18 to the wound, however, is sufliciently strong to cleanse, stimulate, and carry away foreign matter from the wound. The slightly higher temperature of the water in the jet stream enhances the effect of the stream itself and insures that the surrounding bath will be maintained at a comfortable temperature.

During this fluid therapy treatment, excess treating fluid and foreign matter from the wound will flow through the outlet 27 and the discharge tube 29. It is a particularly important aspect of this invention to provide the outlet 28 above the Wound and the nozzle opening 18 so that the wound will be completely immersed in the bath and so that the stream from the opening 18 will not strike the wound without first passing through its fluid cushion.

One liter of fluid in the bag 20 will supply sufficient fluid to the cup 11 for a 20-minute treatment. If desired, a clamp 32 may be employed to shut off the flow of fluid from the bag.

It should be appreciated that the tube 19 may be connected directly to a water tap. ,In this instance, however, an anti-siphoning device, such as a one-way check valve, should be provided in the tube 19 to protect the water supply from possible contamination and care should be exercised in selecting the proper water temperature and flow rate.

The discharge conduit 29 may empty directly into the toilet bowl or, as is illustrated, may be connected to the bag 31 by the tube 30. The use of the bag 31 is particularly desirable if a highly staining treating agent is employed, such as, for example, potassium permanganate, since these agents tend to stain the porcelain surface of the toilet bowl. It may also be desirable to employ the bag 31 if the device is used on ahospi'tal commode to eliminate the task of emptying and cleaning the catch basin. More-over, the substantially completely closed system illustrated in FIGURES 1 and 2 is relatively odor-free during use.

Referring now to FIGURE 3, a fluid therapy device 40, according to a further aspect of this invention, is illustrated. The device 40 is particularly suited for the fluid therapy treatment of wounds that are located in vertical planes when the patient is ambulatory, such as for example a wound W on the leg L. The device 40 includes a cup 41 having a rim 42 that is shaped to confine only the wound W and areas of the skin that are immediately adjacent the wound. I

The cup 41 may be molded or otherwise formed from a flexible material such as plastic or rubber, or any other flexible material that will not be afiected by or react with medicaments, warm water, and the skin of a patient. At least the rim 42 of the cup 41 should be sufliciently flexible to conform to the contour of the area being treated so that the rim 42 will press into the skin to form a fluid-tight seal.

An aperture 43 is provided in the bottom of the cup 41 and a stiff plastic tube 44 extends through the aperture and is sealed thereto, for example, by a suitable heat sealing technique. The tube 44, therefore, forms a fluidtight seat with the aperture 43 and axial movement of the tube 44 relative to the aperture is prevented. The bottom of the cup 41 should be sufficiently flexible to permit a universal movement of the tube 44. If desired, however, a grommet (not shown) may be provided in the aperture 43 in the manner set forth in FIGURES 1 and 2.

The end of the tube 44 in the cup 41 is provided with a small nozzle opening 45 and the other end of the tube 44 is fitted into a length of rubber tubing 46. The tubing 46 is in communication with .a treating agent source (not shown) which may be similar to the bag 20 or may be a water tap.

The cup 41 is pressed against the skin to form a fluidtight seal by elastic straps 47. The straps 47 are fixed to the bottom of the cup 41 by clips 48 which may be integrally molded with the cup body.

An overflow outlet 49 is provided in the bottom of the cup 41 adjacent to the sidewall. The cup 41 is strapped to the body so that this outlet 49 will be above the wound W and the nozzle opening 45. The overflow outlet 49 is in fluid communication with a discharge conduit 50. A length of rubber tubing 51 is fitted over the end of the discharge conduit 50 and the tubing 51 may empty into a bag (not shown) or a toilet bowl.

In operation for a typical fluid therapy treatment, the cup 41 is positioned so that the rim 42 is in a horizontal plane. With the tubes 46 and 51 closed by suit-able clamps (not shown), the cup 41 is filled with a treating agent such as water and with the cup 41 in its horizontal position, the straps are Wrapped around the body so that the rim confines the wound to be treated. The patient may then stand or be seated so that the device 40 is in its illustrated position.

The clamps are then removed from the tubes 46 and 51 so that a fine jet stream will be directed through the fluid confined in the cup 41 and toward the wound W to cleanse, stimulate, and carry away foreign matter from the wound. Foreign matter from the wound and excess treating fluid will flow through the outlet 49 and the discharge conduit 50. The patient may grasp the end of the tube 44 and move it about to direct the stream from the nozzle opening 45 to different portions of the wound W.

Referring now to FIGURES 4 and 5, a fluid therapy device 60, according to a still further aspect of this invention, is illustrated. The device isv particularly suited for the fluid therapy treatment of wounds that are located in horizontal planes when the patient is not ambulatory, such as abdominal wounds. The device 60 includes a cup 61 having inwardly turned, flat edge portion 62. The edge portion 62 is provided with a pressuresensitive adhesive coating 63 that seals the portion 62 to the skin that is immediately adjacent to the wound and provides a fluid-tight seal between the cup 61 and the skin.

The cup is fabricated from flexible plastic or any flexible material that will not be affected by or react with medicaments, warm Water, and the skin of a patient.

An aperture 64 is provided in the cup 61 and a stiff plastic tube 65 extends through the aperture and is removably sealed thereto, for example, by clip 65a. The tube 65, therefore, forms a fluid-tight seal with the aperture 43 and axial movement of the tube 65 relative to the aperture is prevented. The cup 61 should be sufficiently flexible to permit a universal movement of the tube 65.

The end of the tube 65 in the cup 61 is provided with a small nozzle opening 66 and the other end of the tube 65 is fitted into a length of rubber tubing 67. The tubing 67 is in communication with a treating agent source (not shown) which may be similar to the bag 20, or may be a water tap.

An overflow outlet 68 is provided in the cup adjacent to one end. For purposes that will hereinafter become apparent, the cup 61 is adhe-sively sealed to the skin of the patient so that the outlet 68 is located in the direction of the patients feet and is above the wound and the nozzle opening 66. The overflow oulet 68 is in fluid communication with a dischrage conduit 69. A length of rubber tubing 70 is fitted over the end of the discharge conduit 69 and the tubing 70 may empty into a bag (not shown) or a toilet bowl.

In operation for a typical fluid therapy treatment, the cup 61 is first sealed to the skin immediately adjacent to the wound. During this sealing operation, the tube 67 is blocked by a suitable clamp (not shown) and the tube 67 is removed from the tube 65. The tube 70 is removed from the discharge conduit 69 and a suitable treating agent, such as water, is poured into the discharge conduit to fill the cup 61. After the cup 61 is filled, the tubes 70 and 67 are replaced and the clamp on the tube 67 is removed.

A fine jet stream is directed through the fluid confine-d in the cup 61 and toward the wound to cleanse, stimulate, and carry away foreign matter from the wound. Foreign matter from the wound and excess treating fluid will flow through the outlet 68 and the discharge conduit 69. The patient may grasp the end of the tube 65 and move it about to direct the stream from the nozzle opening 66 to different portions of the wound.

After the above-described liquid fluid therapy treatment has been completed, the tube 67 is again clamped and the patient is permitted to stand, thus draining substantialy all of the treating agent from the cup 61. The tube 70 is removed from the discharge conduit 69 and this conduit is closed by a stopper (not shown). The

tube is removed from the opening 64 and this opening is likewise closed by a stopper (not shown). A suitable gas such as, for example, oxygen is admitted to the cup 61 by inserting a hollow needle through one of the stoppers until the flexible cup is inflated. The patient may then be ambulatory until his next fluid therapy treatment. The cup 61 thus provides a sterile dressing between treatments, but allows the Wound to be bathed in a suitable gas, such as oxygen, to promote healing.

The invention is not restricted to the slavish imitation of each and every one of the details described above, which have been set forth merely by way of example. Obviously, devices may be provided which change, elim inate, or add certain specific details without departing from the invention.

What is claimed is:

A device for treating a wound comprising a cup for enclosing said wound and areas immediately adjacent to said wound to define a substantially closed chamber, said cup having a relatively rigid bottom wall and a side wall, the upper edge of said side wall defining a rim for effecting a fluid-tight seal with said adjacent areas, said cup having a narrowed peak portion, .a treating agent bath in said chamber, an inlet tube extending through the bottom wall of said cup opposite said wound, means for mounting said inlet tube and permitting angular movement of said inlet tube relative to said relatively rigid bottom wall but preventing any substantial degree of axial movement of said tube relative to said relatively rigid bottom wall, a bag 'for holding a supply of treating agent, a conduit connecting said bag to said inlet tube, said inlet tube having a nozzle opening at its end for directing a stream of treating agent into said chamber, through said bath, and toward said wound to thereby irrigate and cleanse the wound, a discharge opening in said peak portion of the cup above the wound and the nozzle opening, and resilient straps fixed to said cup and having end portions for connecting said cup to a toilet seat.

References Cited by the Examiner UNITED STATES PATENTS 1,385,346 7/1921 Taylor 128248 1,405,355 1/1922 Thompson 128350 2,280,915 4/1942 Johnson 128-350 2,947,995 8/ 1960 Saulson 46 3,026,874 3/ 1962 Stevens l28-260 3,075,526 1/1963 Morris 128-227 FOREIGN PATENTS 114,443 12/ 1941 Australia. 1,013,782 5/1952 France.

641,061 8/1950 Great Britain.

RICHARD A. GAUDET, Primary Examiner.

R. L. FRINKS, Assistant Examiner. 

